Healthcare Provider Details

I. General information

NPI: 1952593527
Provider Name (Legal Business Name): DAVID FALDEN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NOCATEE VILLAGE DR
PONTE VEDRA FL
32081-5097
US

IV. Provider business mailing address

8614 WESTWOOD CENTER DR FL 9
VIENNA VA
22182-2442
US

V. Phone/Fax

Practice location:
  • Phone: 904-825-4525
  • Fax: 904-825-4520
Mailing address:
  • Phone: 703-847-8899
  • Fax: 571-223-6780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4219
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: